EXCLUSIVE: Tri-City creating hospital prison unit

Facility will serve inmates from Donovan state prison

The new year brought a new type of patient to Tri-City Medical
Center: state prisoners.

Nancy Kincaid, director of communications for California Prison
Healthcare Services, said Friday that a new deal with the
Oceanside-based hospital that took effect Jan. 1 means inmates from
the Richard J. Donovan Correctional Facility near Otay Mesa are now
being treated at Tri-City.

The hospital will dedicate an entire floor to serving inmates,
Kincaid said. She said Tri-City is using guidelines from the
California Department of Corrections and Rehabilitation to train
the nurses, doctors, technicians and other health care personnel
who will work there.

Hospital officials declined to comment last week, saying the
state had asked them not to discuss the matter.

It was unclear how much revenue or profit the contract to treat
inmates would bring Tri-City, which has struggled to replace
business lost when a major doctors group became affiliated with
Scripps Health in early 2009.

The hospital is licensed for 397 beds but has been running below
its projected patient volume, averaging 184 occupied beds per day,
according to a report released Dec. 16. Budget projections
estimated an average of 207 occupied beds per day.

In a Dec. 30 e-mail to Tri-City board members, obtained by the
North County Times, hospital Chief Executive Larry Anderson said
Tri-City would mostly handle surgeries and hospitalizations for
inmates. The memo said Paradise Valley Hospital in southern San
Diego also contracts with the prison system and would probably
handle any emergency care.

Kincaid said Alvarado Hospital ---- which previously held the
contract with the prison system ---- had a 17-bed secure unit to
treat inmate patients. She said that unit averaged eight patients
per day, and said that a similar number of patients are likely to
come to Tri-City.

Kincaid said trade secrets prevent the state from sharing the
details of the contract with the public. But she said state law
prohibits the Department of Corrections from paying more than 130
percent of Medicare rates for hospitalization.

Kincaid said each prisoner treated at Tri-City will be
accompanied at all times by two state corrections officers, at
least one of whom will be armed.

Sources said hospital administrators announced the agreement to
Tri-City employees at a recent meeting and distributed a handout
about working with prisoners entitled "Custody Awareness ---- Care
and Conversation."

The handout tells workers that "custody patients have the same
patient rights as all patients with safety considerations."

Under the heading "Do not enter a custody patient room alone,"
the handout tells workers to make sure they are always accompanied
by a correctional officer before they move to a patient's
bedside.

The document also cautions workers to modify their bedside
manner with inmates: "Calling a custody patient 'honey' or 'dear'
or 'sweetie' is not acceptable," it says.

Employees must also remove all needles, syringes, scissors,
thermometers, pens, razors, combs or paper clips from a patient's
room before leaving, and must remove and dispose of all
one-time-use medical equipment, like intravenous medicine bags and
tubing, outside a patient's room.